Articles Posted in Nursing Home Negligence

When someone is unable to care for themselves, they will often end up staying in some sort of residential institution, such as a nursing home or a rehabilitation center. These facilities are supposed to care for individuals and make their lives easier. Maryland law imposes a duty on these facilities to care for their residents, and if residents suffer abuse or neglect, such as neglecting medical needs or causing psychological harm, they can hold the institution liable in a civil negligence suit.

One of the most common types of lawsuits filed against a nursing home is a medical malpractice claim, particularly for failing to transport a patient to the hospital when they clearly needed to be treated by a professional. In a recent opinion, a state supreme court considered one of these cases, affirming a jury verdict awarding over $2.2 million dollars to the plaintiff.

According to the court’s written opinion, the seventy-six-year-old plaintiff began experiencing significant knee pain in her right knee, causing her to undergo surgery in early 2014. To recover from the surgery, the plaintiff was transported to a rehabilitation center. While in the center, the plaintiff continued to experience excruciating pain and then began showing signs of confusion in mid-March of 2014. The notes taken by nursing assistants caring for her indicated her confusion, which got worse throughout the night, an elevated heart rate, massive bruising on her leg, and that her right foot curled inward and appeared to be limp. According to the notes, the plaintiff told the nursing assistants that she was in the worst pain of her life, asking them to shoot her to end her misery.

More and more Maryland nursing homes are having their residents sign arbitration agreements, raising concerns for victims of nursing home injuries, abuse and negligence. Arbitration agreements force residents to settle disputes with the nursing home through arbitration, a private and confidential process with no possibility of appeal, rather than having the option to bring a civil negligence suit in court. Essentially, by signing an arbitration agreement, which may or may not be obvious and apparent in the nursing home’s contract and forms, Maryland residents may be waiving their right to sue if something goes wrong.

Arbitration agreements come in many forms, however, and just because a resident signed one does not necessarily mean that they have unequivocally waived their right to sue. Many arbitration agreements dictate a specific type of claim that must be settled in arbitration, leading to eventual disputes over whether or not a plaintiff’s claim falls into that category. For example, a state appellate court recently issued an opinion considering such a dispute in a wrongful death and negligence claim. According to the court’s written opinion, the resident was admitted to the nursing home in 2013 with various cognitive and physical ailments, including Parkinson’s disease, heart disease, dementia, psychosis, functional quadriplegia, and chronic kidney disease. When admitted, her son, as her representative, signed an “Admissions Agreement.” This agreement included an arbitration clause for “any dispute as to medical malpractice,” which was further defined as disagreement over whether medical services rendered to the resident was necessary, unauthorized, or improperly, negligently, or incompetently rendered.

In 2016, a little over three years after living in the home, a nursing assistant was pushing the resident back to her room after breakfast. While on their way, the resident’s foot got caught in a loose cord, which catapulted her headfirst onto the floor, breaking her neck. Tragically, the resident died five days later due to her injuries. In the aftermath, her estate sued the nursing home for wrongful death and negligence, and the nursing home moved to compel arbitration under the Admissions Agreement’s arbitration provision. However, the court found that the nursing home could not compel arbitration under their agreement, because the agreement only covered disagreements over medical services rendered. Although the incident led to medical services and medical evidence was produced against the defendant nursing home, the dispute was not itself over medical malpractice, and thus the nursing home could not force the plaintiffs to arbitrate.

Expert witnesses can be extremely helpful in Maryland nursing home abuse cases. They can help explain to the judge or the jury the extent of the injuries, or how the incident occurred. Typically, expert witnesses are very helpful for plaintiffs and may help them win their cases against negligent nursing homes. However, there are some instances where expert testimony is required—not just helpful—and plaintiffs might even lose if they do not have it.

Recently, a state appellate court issued a decision discussing when expert witnesses are needed to prove a claim of negligence and when they are not. According to the court’s written opinion, the complaint was brought as a wrongful death suit against the nursing home, in part for negligent staffing. The victim, a 71-year-old resident in the home, had been living in the facility for eleven years. One night, a licensed practical nurse (LPN) entered his room during her night shift, saw vomit on the resident’s clothing, and noticed that his stomach was distended. Concerned, the LPN reported what she had seen to other staff members but took no further action. Importantly, there was no Registered Nurse (RN) on staff during the night shift. It wasn’t until around 12 hours later, the next morning, when an RN actually examined the resident and had him taken to the emergency room. The resident was treated in the emergency room and then the intensive care unit, but unfortunately died that night from bowel complications.

The resident’s family and estate brought a wrongful death suit against the nursing home, claiming that the facility was negligent by not staffing the night shift with someone who could have properly assessed the victim’s condition. According to the plaintiffs, had there been an RN or someone else on staff, they likely would have realized the severity of the resident’s condition and transferred him to the hospital earlier, which may have saved his life. The defendants attempted to dismiss the claim against them, arguing that the staffing decision required professional nursing judgment, making it professional negligence, rather than ordinary negligence. A key difference between the two is that professional negligence requires expert testimony, something the plaintiffs did not have.

In general, the damages that are available to a Maryland personal injury plaintiff are designed to put the plaintiff back in the same position they were in before the defendant’s negligent actions impacted their life. Thus, most damages are referred to as “compensatory” damages, because they compensate a plaintiff for the injuries they suffered as a result of the defendant’s conduct. However, in some cases, punitive damages may also be appropriate.

Punitive damages differ from compensatory damages because the focus of a punitive damages award is not on the plaintiff, but on the defendant. Punitive damages are designed to punish the defendant for especially egregious behavior, and to deter future parties from engaging in similar behavior. For this reason, obtaining punitive damages requires proving additional facts. In Maryland, punitive damages cannot be obtained unless the plaintiff can show that the defendant acted with “actual malice.” A recent case illustrates how it can be difficult to obtain punitive damages.

In this case, the plaintiff was the estate of an older woman who passed away while living at the defendant nursing home. After the woman’s death, her estate (the plaintiff) filed a wrongful death claim against the nursing home, claiming that its negligence was the cause of woman’s death. Among other claims, the estate sought punitive damages based on staff members’ failure to care for the woman. The trial court preliminarily approved the claim for punitive damages, and the defendant immediately appealed.